Pemphigus, herpes gestationis, bullous pemphigoid and dermatitis herpetiformis are blistering skin diseases, all of which are strongly associated with so-called autoimmune phenomena. The studies in this laboratory have been mainly concerned with the identification and characterization of serum and in vivo bound antibodies in the latter 3 diseases. Our major investigations have centered around the mechanisms of tissue destruction, ultrastructure, and ultrastructural localization of these antibodies. Gastrointestinal abnormalities, which are very similar to those seen in gluten sensitive enteropathy, occur in dermatitis herpetiformis and are also under active study. Immunogenetic considerations with regard to HLA associations and the identification of specific B-lymphocyte antigens have provided us with tools required to study the triggering mechanisms involved in the early stages of an abnormal immune response. Another major aspect of our work is the study of the effect of sulfones on neutrophilic exudative disorders. As sulfones dramatically alleviate dermatitis herpetiformis and erythema elevatum diutinum, we are using animal models of inflammation and serum and blister fluids from patients to study their effect on complement activation, deposition and neutrophilic chemotaxis.